Abstract
Objective: The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) is a widely recognized tool with exceptional reliability and validity in evaluating and diagnosing PTSD. This study aimed to determine the predictive values of CAPS-5 assessed early postinjury for subsequent development of PTSD during a 2-year follow-up period.
Methods: Patients with moderate to severe physical injuries were recruited from a trauma center at a university hospital in South Korea between June 2015 and January 2021. At baseline, 1,142 patients underwent evaluations using CAPS-5 for the diagnosis of acute stress disorder (ASD) along with total scores. They were followed up for PTSD using the CAPS-5 evaluations at 3, 6, 12, and 24 months post-baseline. Area under receiver operating curve (AUROC) analyses were conducted to identify predictive values of the CAPS-5 for later PTSD development.
Results: CAPS-5 diagnosis of ASD at baseline displayed fair to failed performance (AUROCs: 0.555–0.722) for predicting follow-up PTSD. However, CAPS-5 scores of ≥15 exhibited good to fair predictive accuracy (AUROCs: 0.767–0.854) for later PTSD development. Notably, for patients with intentional injuries or a history of previous trauma, a higher CAPS-5 score of ≥16 showed improved predictive accuracy.
Conclusion: A CAPS-5 score of ≥15 would be an effective and practical cutoff for early prediction of PTSD following physical injuries. In cases of intentional injuries or a documented trauma history, a cutoff of ≥16 may offer enhanced predictive precision. Future research in diverse settings and populations is needed to confirm the generalizability of our findings.
J Clin Psychiatry 2024;85(3):24m15267
Author affiliations are listed at the end of this article.
Abstract
Objective: The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) is a widely recognized tool with exceptional reliability and validity in evaluating and diagnosing PTSD. This study aimed to determine the predictive values of CAPS-5 assessed early postinjury for subsequent development of PTSD during a 2-year follow-up period.
Methods: Patients with moderate to severe physical injuries were recruited from a trauma center at a university hospital in South Korea between June 2015 and January 2021. At baseline, 1,142 patients underwent evaluations using CAPS-5 for the diagnosis of acute stress disorder (ASD) along with total scores. They were followed up for PTSD using the CAPS-5 evaluations at 3, 6, 12, and 24 months post-baseline. Area under receiver operating curve (AUROC) analyses were conducted to identify predictive values of the CAPS-5 for later PTSD development.
Results: CAPS-5 diagnosis of ASD at baseline displayed fair to failed performance (AUROCs: 0.555–0.722) for predicting follow-up PTSD. However, CAPS-5 scores of ≥15 exhibited good to fair predictive accuracy (AUROCs: 0.767–0.854) for later PTSD development. Notably, for patients with intentional injuries or a history of previous trauma, a higher CAPS-5 score of ≥16 showed improved predictive accuracy.
Conclusion: A CAPS-5 score of ≥15 would be an effective and practical cutoff for early prediction of PTSD following physical injuries. In cases of intentional injuries or a documented trauma history, a cutoff of ≥16 may offer enhanced predictive precision. Future research in diverse settings and populations is needed to confirm the generalizability of our findings.
J Clin Psychiatry 2024;85(3):24m15267
Author affiliations are listed at the end of this article.
This content is restricted to subscribers
References (28)
- Wiseman T, Foster K, Curtis K. Mental health following traumatic physical injury: an integrative literature review. Injury. 2013;44(11):1383–1390. PubMed CrossRef
- Bryant RA, O’Donnell ML, Creamer M, et al. A multisite analysis of the fluctuating course of posttraumatic stress disorder. JAMA Psychiatry. 2013;70(8):839–846. PubMed CrossRef
- Beierl ET, Böllinghaus I, Clark DM, et al. Cognitive paths from trauma to posttraumatic stress disorder: a prospective study of Ehlers and Clark’s model in survivors of assaults or road traffic collisions. Psychol Med. 2020;50(13):2172–2181. PubMed CrossRef
- Pozzato I, Tran Y, Gopinath B, et al. The contribution of pre-injury vulnerability to risk of psychiatric morbidity in adults injured in a road traffic crash: comparisons with non-injury controls. J Psychiatr Res. 2021;140:77–86. PubMed CrossRef
- Heron-Delaney M, Kenardy J, Charlton E, et al. A systematic review of predictors of posttraumatic stress disorder (PTSD) for adult road traffic crash survivors. Injury. 2013;44(11):1413–1422. PubMed CrossRef
- Fullerton CS, Ursano RJ, Epstein RS, et al. Gender differences in posttraumatic stress disorder after motor vehicle accidents. Am J Psychiatry. 2001;158(9):1486–1491. PubMed CrossRef
- Blanchard EB, Hickling EJ, Freidenberg BM, et al. Two studies of psychiatric morbidity among motor vehicle accident survivors 1 year after the crash. Behav Res Ther. 2004;42(5):569–583. PubMed CrossRef
- Bryant RA, Nickerson A, Creamer M, et al. Trajectory of post-traumatic stress following traumatic injury: 6-year follow-up. Br J Psychiatry. 2015;206(5):417–423. PubMed CrossRef
- Jenewein J, Wittmann L, Moergeli H, et al. Mutual influence of posttraumatic stress disorder symptoms and chronic pain among injured accident survivors: a longitudinal study. J Trauma Stress. 2009;22(6):540–548. PubMed CrossRef
- Galatzer-Levy IR, Ankri Y, Freedman S, et al. Early PTSD symptom trajectories: persistence, recovery, and response to treatment: results from the Jerusalem Trauma Outreach and Prevention Study (J-TOPS). PLoS One. 2013;8(8):e70084. PubMed CrossRef
- van Zuiden M, Frijling JL, Nawijn L, et al. Intranasal oxytocin to prevent posttraumatic stress disorder symptoms: a randomized controlled trial in emergency department patients. Biol Psychiatry. 2017;81(12):1030–1040. PubMed CrossRef
- Weather FW, Blake DD, Schnurr PP, et al. The clinician-administered PTSD scale for DSM-5 (CAPS-5). Accessed March 13, 2017. http://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp
- Hunt JC, Chesney SA, Jorgensen TD, et al. Exploring the gold-standard: evidence for a two-factor model of the clinician administered PTSD scale for the DSM-5. Psychol Trauma. 2018;10(5):551–558. PubMed CrossRef
- Geier TJ, Hunt JC, Nelson LD, et al. Detecting PTSD in a traumatically injured population: the diagnostic utility of the PTSD Checklist for DSM-5. Depress Anxiety. 2019;36(2):170–178. PubMed CrossRef
- Shalev AY, Gevonden M, Ratanatharathorn A, et al. Estimating the risk of PTSD in recent trauma survivors: results of the International Consortium to Predict PTSD (ICPP). World Psychiatry. 2019;18(1):77–87. PubMed
- Kim JW, Kang HJ, Bae KY, et al. Development of a biomarker-based diagnostic algorithm for posttraumatic syndrome after physical injury: design of the BioPTS study. Psychiatry Investig. 2017;14(4):513–517. PubMed CrossRef
- Baker SP, O’Neil B, Haddon W Jr., et al. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 1974;14(3):187–196. PubMed
- Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet. 1974;2(7872):81–84. PubMed
- Weathers FW, Bovin MJ, Lee DJ, et al. The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5): development and initial psychometric evaluation in military veterans. Psychol Assess. 2018;30(3):383–395. PubMed CrossRef
- Geoffrion S, Goncalves J, Robichaud I, et al. Systematic review and meta-analysis on acute stress disorder: rates following different types of traumatic events. Trauma Violence Abuse. 2022;23(1):213–223. PubMed CrossRef
- Sarason IG, Johnson JH, Siegel JM. Assessing the impact of life changes: development of the life Experiences Survey. J Consult Clin Psychol. 1978;46:932–946. PubMed CrossRef
- Hepp U, Moergeli H, Buchi S, et al. Post-traumatic stress disorder in serious accidental injury: 3-year follow-up study. Br J Psychiatry. 2008;192:376–383. PubMed CrossRef
- Weathers FW, Litz BT, Keane TM, et al. The PTSD Checklist for DSM-5 (PCL-5). National Center for PTSD; 2013.
- Kennedy AC, Prock KA. “I still feel like I Am not normal”: a review of the role of stigma and stigmatization among female survivors of child sexual abuse, sexual assault, and intimate partner violence. Trauma Violence Abuse. 2018;19(5):512–527. PubMed
- Ozer EJ, Best SR, Lipsey TL, et al. Predictors of posttraumatic stress disorder and symptoms in adults: a meta-analysis. Psychol Bull. 2003;129(1):52–73. PubMed CrossRef
- Bryant RA. Acute stress disorder as a predictor of posttraumatic stress disorder: a systematic review. J Clin Psychiatry. 2011;72(2):233–239. PubMed
- Weathers FW, Bovin MJ, Lee DJ, et al. The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5): development and initial psychometric evaluation in military veterans. Psychol Assess. 2018;30(3):383–395. PubMed CrossRef
- Aziz MA, Kenford S. Comparability of telephone and face-to-face interviews in assessing patients with posttraumatic stress disorder. J Psychiatr Pract. 2004;10:307–313. PubMed CrossRef
Please sign in or purchase this PDF for $40.
Save
Cite